Individual provider · NPI-1

Shoheb S Ali, M.D.

Hospitalist · Lawrenceville, GA

NPI number1477908192

StatusActive

Last updated in NPPESMar 5, 2023

Details

NPI: 1477908192
Entity type: Individual (NPI-1)
Name: Shoheb S Ali
Credential: M.D.
Sex: Male
Sole proprietor: No
Enumeration date: May 2, 2016
Certification date: Mar 5, 2023
Last updated: Mar 5, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
208M00000X	Hospitalist	86041	GA	Yes
207R00000X	Internal Medicine	MD17430	RI
207R00000X	Internal Medicine	86041	GA
390200000X	Student in an Organized Health Care Education/Training Program	–	–

Practice location

1000 Medical Center Blvd
Lawrenceville, GA 30046-7694

Phone 678-312-3294 · Fax 678-312-3282

Mailing address

1000 Medical Center Blvd
Lawrenceville, GA 30046-7694

Phone 678-312-3294 · Fax 678-312-3282

Other practice locations

593 Eddy St
Providence, RI 02903-4923

Phone 401-444-3985 · Fax 401-444-3986

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